PB2649: THE SURGICAL OUTCOMES IN PEDIATRICS PATIENTS WITH HEMOPHILIA, THE ROYAL HOSPITAL EXPERIENCE, OMAN
Authors: Alia Al Hajri, Rahaf Rafea, Ibrahim Al Ghaithi
Journal: HemaSphere (2023)

Topic: 33. Bleeding disorders (congenital and acquired) Background: Pediatrics patients with Hemophilia who might need surgical intervention are a group of patients that can be challenging for treating physicians. We aim to explore the effectiveness of the preoperative preparation and postoperative measures in managing surgical-related hemorrhagic complications among pediatrics patients with Hemophilia in the Omani population. Aims: Exploring the effectiveness of the preoperative preparation and postoperative measures in managing surgical-related hemorrhagic complications among pediatrics patients with Hemophilia in the Omani population. Methods: We conducted a retrospective descriptive longitudinal study between the period of 2010 to 2022. All pediatric patients with hemophilia who are following up in the Royal Hospital were eligible for this study. We analyzed data of forty-four pediatric patients with hemophilia. Types of surgical intervention, preoperative preparation and postoperative measures were recorded. The data was obtained from patients` electronic data “AlShifa’‘, and collected in a data collection sheet in excel and then transferred to Epidat Results: Twenty-nine (65.9%) from our pediatric patients with hemophilia underwent surgical interventions. The interventions included: fourteen (48.28%) circumcisions, five (17.24) dental extractions, six (20.69%) patients underwent both procedures and four (13.79%) had other procedures. All of our patients were prepared preoperatively by factor replacement. Factor VIII (8) was given in twenty-eight (96.55%) patients who were diagnosed with Hemophilia A and factor IX (9) was given in one (3.44%) patient who was diagnosed with Hemophilia B. Among those patients, eight patients (27.5%) had surgical-related hemorrhagic complications postoperatively, which mainly include swelling at the site of the surgical incision. Those surgical-related hemorrhagic complications were managed by administering factor VIII alone in five (62.5%) of the patients. Factor VIII along with tranexamic acid was given in two (25%) of the patients and factor IX in one (12.5%) patient. None of our pediatric patients with hemophilia was expired or developed serious or life-threatening condition that is related to these surgical interventions. Summary/Conclusion With careful planning and sufficient factor replacement, surgical procedures can be performed safely in children with hemophilia in Oman. However, some patients may still experience bleeding, and ongoing hematological involvement and oversight are necessary to manage this complication. Bleeding is particularly common following certain types of surgical procedures, highlighting the importance of close follow-up and continuous factor coverage for these patients. Therefore, a proactive approach that involves diligent monitoring and timely intervention by healthcare professionals is recommended to optimize outcomes and ensure the safety of children with hemophilia undergoing surgical procedures. Keywords: Hemorrhage, Hemophilia B, Hemophilia A, Hemophilia